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创伤性脑损伤患者人口统计学特征的变化:一个与老龄化相关的问题。

Changing Demographic Profiles of Patients With Traumatic Brain Injury: An Aging Concern.

作者信息

Liew Terence Yi Song, Ng Jun Xuan, Jayne Chan Hui Zhen, Ragupathi Tharun, Teo Colin Kok Ann, Yeo Tseng Tsai

机构信息

Division of Neurosurgery, University Surgical Cluster, National University Hospital, Singapore, Singapore.

Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.

出版信息

Front Surg. 2019 Jul 3;6:37. doi: 10.3389/fsurg.2019.00037. eCollection 2019.

Abstract

Trauma continues to be a common cause of mortality in Singapore. By understanding the epidemiology of Traumatic Brain Injury (TBI), healthcare professionals can be better equipped to tackle the increasing socioeconomic burden of disease, adopting better strategies in healthcare planning. A retrospective review of 367 patients admitted with TBI to a tertiary medical institution from January to December 2014 was performed, studying demographic profiles, injury details and outcomes of these patients. Data was retrieved from the National Trauma Registry and the institution's database. Two hundred thirty-four of the 367 patients included in this study fell into two age groups--19 to 40 years and ≥65 years. 58% of the TBI population were aged >60. Predominant mechanism of injuries in these groups were road traffic accidents and unwitnessed falls respectively. 39% of the Elderly group were on antiplatelet/anticoagulant agents ( < 0.001). While aggressive surgical intervention was more common in younger patients ( < 0.001), the elderly group had significantly longer lengths of hospital stay ( < 0.001). Though Glasgow Outcome Scale (GOS) scores at discharge were not significantly different between the two groups, elderly patients showed greater percentages of post-injury improvement subsequently. The demographics of TBI patients appears to have shifted toward an older population as compared to a decade ago, with an increased incidence of falls, highlighting a huge healthcare concern. We hope that this study will drive further nationwide studies in future, looking at the incidence and prevalence of TBI, and with the focus on tackling preventable causes of TBI.

摘要

在新加坡,创伤仍然是常见的死亡原因。通过了解创伤性脑损伤(TBI)的流行病学,医疗保健专业人员能够更好地应对疾病日益增加的社会经济负担,在医疗规划中采用更好的策略。对2014年1月至12月入住一家三级医疗机构的367例TBI患者进行了回顾性研究,分析这些患者的人口统计学特征、损伤细节和预后。数据从国家创伤登记处和该机构的数据库中获取。本研究纳入的367例患者中,有234例分为两个年龄组——19至40岁和≥65岁。TBI人群中58%的患者年龄>60岁。这些组中主要的损伤机制分别是道路交通事故和无人目睹的跌倒。老年组中39%的患者正在服用抗血小板/抗凝剂(<0.001)。虽然积极的手术干预在年轻患者中更为常见(<0.001),但老年组的住院时间明显更长(<0.001)。尽管两组出院时的格拉斯哥预后量表(GOS)评分没有显著差异,但老年患者伤后改善的比例随后更高。与十年前相比,TBI患者的人口统计学特征似乎已转向老年人群,跌倒发生率增加,这凸显了一个重大的医疗问题。我们希望这项研究将推动未来进一步的全国性研究,关注TBI的发病率和患病率,并重点解决TBI的可预防原因。

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